Disruption in tooth development and eruption patterns or structural
integrity of individual teeth
• Caries; extractions; evidence of periodontal disease
• Inability or unwillingness of parents or caregiver to provide child
with dental care; lack of access to dental care
• Lack of knowledge of appropriate dental hygiene practices
• Malocclusion; plaque; toothache
• Loose teeth; premature loss of primary teeth
• Erosion of enamel
• Barriers to self-care
• Ineffective oral hygiene
• Nutritional deﬁcits
• Chronic use of coffee, tea, red
• Sensitivity to cold
• Sensitivity to heat
• Chronic vomiting
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Values and beliefs
The individual will
• Brush teeth with minimal supervision.
• Demonstrate good brushing technique.
• Not show evidence of dental caries, periodontal disease, or maloc-
• Reduce quantity of cariogenic foods in his or her diet.
• Show evidence of good daily oral hygiene.
SUGGESTED NOC OUTCOME
Oral Hygiene; Self-Care: Oral Hygiene
INTERVENTIONS AND RATIONALES
Determine: Assess dental history; primary and secondary tooth devel-
opment; frequency of visits to dentist; frequency of brushing; condi-
tion of the teeth; nutritional status; medications; socioeconomic sta-
tus. Assessment of these factors will help to identify appropriate
Perform: Provide tooth brush, toothpaste, and dental ﬂoss.
Schedule times for brushing and have patient begin keeping a
record. Keeping a record will promote compliance.
Inform: Teach child principles of good oral hygiene by using teaching
methods appropriate to his age-group to foster compliance.
Teach the child and his or her parents or caregiver about the rela-
tionship between diet and dental health. Show the child pictures that
promote good dental health and pictures of foods that lead to den-
tal decay. If the child can read, teach him or her to read labels;
teach him or her to avoid products with excessive sucrose. Sucrose
is a simple sugar that promotes dental decay.
Demonstrate good brushing technique. Stress the importance of
having teeth feel clean rather than the need to follow a speciﬁc pro-
Attend: Encourage parents to create a pleasant mealtime environment
with nutritious foods made to look appealing to a child so that the
child will learn to recognize nutritious foods.
Give positive reinforcement for good choices. Be supportive to the
parents as they try to help the child modify diet to include more
nutritional foods. It is not easy to teach children to make right food
choices, and parents beneﬁt from encouragement to keep reinforcing
good healthy choices.
Encourage ample ﬂuid intake to keep gums well hydrated.
Adequate ﬂuids promote healthy gums.
Manage: Refer to dentist for assessment of dental health.
Schedule a follow-up appointment with parents to ensure they
have taken child to the dentist.
Where it is indicated, refer to a nutritionist for help in modifying
SUGGESTED NIC INTERVENTIONS
Oral Health Maintenance; Oral Health Promotion; Teaching:
Melvin, C. S. (2006, January–February). A collaborative community based
oral care program for school age children. Clinical Nurse Specialist, 20(1),